How can I find out the cost of a medical procedure?

To find out the cost of a specific medical procedure, you should contact your healthcare provider's billing department directly and also reach out to your insurance company for coverage details. For a detailed lookup of fee schedules based on CPT code and your specific location, you can utilize specialized tools. Payerprice offers a fee schedule lookup tool designed for users to search with CPT codes and specific locations.

What is a CPT code and why is it important for understanding costs?

CPT stands for Current Procedural Terminology. CPT codes are standardized five-digit codes used by healthcare providers to describe medical, surgical, and diagnostic services to payers for reimbursement. They are crucial for understanding costs because they provide a universal way to identify specific procedures, allowing you to look up prices and verify insurance coverage accurately. Knowing the CPT code for your service is often the first step in getting a precise cost estimate.

Does my insurance cover this procedure?

To determine if your insurance covers a specific procedure, you must contact your insurance provider directly. They can explain your benefits, deductible, co-pays, and any pre-authorization requirements. It's helpful to have the CPT code for the procedure ready when you call, as this will allow them to provide the most accurate information regarding your coverage.

What is the difference between an in-network and out-of-network provider?

An in-network provider has a contract with your health insurance plan to provide services at pre-negotiated rates. This typically results in lower out-of-pocket costs for you, as your insurance company covers a larger portion of the bill. An out-of-network provider does not have such a contract, meaning you may pay a higher percentage of the cost, or even the full cost, out of pocket, as your insurance plan may cover less or none of the service.

Where can I find specific fee schedules for medical services?

For specific fee schedules based on CPT codes and your location, you can use specialized tools. Payerprice offers a fee schedule lookup tool that allows users to search with CPT codes and specific locations to find relevant pricing information. This can help you understand potential costs before a procedure.

CPT 77338 Fee Schedule

Q: What factors affect fee schedules?

Factors that affect fee schedules include Medicare & Medicaid Rates (government-set reimbursement amounts), Private Insurance Rates (negotiated rates between providers and insurance companies), Geographic Location (costs may be higher in urban areas), and Provider Type (hospital providers may have different rates than private practice).

Last Verified: September 2026

Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.

Imrt Tumor Image, A Tumor Image Created For Radiation Treatment. Information From An Intensity-Modulated Radiation Therapy (Imrt) Plan Is Fed Into A Filter On A Linear Accelerator. This Creates A Radiation Energy Pattern That Precisely Matches The Shape Of The Tumor.

Key Fact	Detail
Service Type	Radiology Procedures Radiation Oncology Treatment
Common Place of Service	22 - On Campus Outpatient Hospital 11 - Office
Common Modifiers	None 26 - Professional component 59 - Distinct Procedural Service
Complexity Level	Moderate
Medicare Fee Schedule	View Medicare rates for 77338
Medicaid Fee Schedule	View Medicaid rates for 77338

National average reimbursement for CPT 77338 by major payers:

$569.76

$593.95

$608.39

$713.11

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 77338.

CPT 77338

5 of 25 sample ratesHigher to lower in this preview

Chu Chen
Merrimack Valley Pediatric Associates, Inc.
MAPediatrics PhysicianNPI 1073502985Tax ID 42-484572
$1,247.60Published rate
El Campo Memorial Hospital
TXGeneral Acute Care HospitalNPI 1003192311Tax ID 45-2750258
$628.11Published rate
David Ison
Professional Radiology, Inc.
ILDiagnostic Radiology PhysicianNPI 1861605602Tax ID 31-0667480
$431.10Published rate
Gonzales Healthcare Systems
TXGeneral Acute Care HospitalNPI 1699768705Tax ID 74-1625013
$297.95Published rate
St Davids Healthcare Partnership Lp LLP, Round Rock Medical Center
Lone Star Circle Of Care
TXGeneral Acute Care HospitalNPI 1649223645Tax ID 74-3001674
$198.66Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 77338 vs. Other Radiation Oncology Treatment Codes

The CPT 77338 code is part of the Radiology Procedures services used for Radiation Oncology Treatment. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 77338 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

Code	Complexity	Description
77301-CPT	High	Radiation Treatment Plan, An Intensity-Modulated Radiation Therapy (Imrt) Plan Constructs A Precise 3-D Map Of A Tumor. Radiation Doses Are Targeted To The Mapped Area And Vary By The Tumor Thickness.
77306-CPT	Low	Therapeutic Radiology Service, Teletherapy Isodose Plan; Simple (1 Or 2 Unmodified Ports Directed To A Single Area Of Interest) Includes Basic Dosimetry Calculation(S)
77307-CPT	Moderate	Telethx Isodose Plan Cplx, Teletherapy Isodose Plan Complex Multiple Treatment Areas Tangential Ports The Use Of Wedges Blocking Rotational Beam Or Special Beam Considerations Includes Basic Dosimetry Calculation S
77338-CPT	Moderate	Imrt Tumor Image, A Tumor Image Created For Radiation Treatment. Information From An Intensity-Modulated Radiation Therapy (Imrt) Plan Is Fed Into A Filter On A Linear Accelerator. This Creates A Radiation Energy Pattern That Precisely Matches The Shape Of The Tumor.

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 77338. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 77338 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules

Medicare & Medicaid Rates

Government-set reimbursement amounts

Private Insurance Rates

Negotiated rates between providers and insurance companies

Geographic Location

Costs may be higher in urban areas.

Provider Type

Hospital providers may have different rates than private practice.

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CPT 77338 Fee Schedule

Chu Chen

El Campo Memorial Hospital

David Ison

Gonzales Healthcare Systems

St Davids Healthcare Partnership Lp LLP, Round Rock Medical Center